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    To clot or not to clot? That is the question in central venous catheters.

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    Authors
    Cadman, A
    Lawrance, Jeremy A L
    Fitzsimmons, Lesley
    Spencer-Shaw, Andrea
    Swindell, Ric
    Affiliation
    University of Manchester Medical School, Manchester, UK.
    Issue Date
    2004-04
    
    Metadata
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    Abstract
    AIM: To establish the relationship between the tip position of tunnelled central venous catheters (CVC) and the incidence of venous thrombosis. MATERIALS AND METHODS: A randomly sampled, retrospective review of 428 CVC inserted into 334 patients was performed. The chest radiograph obtained post-catheter insertion, as well as follow-up radiographs, linograms, venograms and Doppler ultrasounds (US), were reviewed. RESULTS: The median follow-up was 72 days (range 1-720 days), with a total follow-up of 23,040 line days. Venous thrombosis occurred in five out of 191 (2.6%) CVC in a distal position (distal third of the superior vena cava (SVC) or right atrium (RA)), five of 95 (5.3%) in an intermediate position (middle third of the SVC) and 20 of 48 (41.7%) in a proximal position (proximal third SVC or thoracic inlet veins). There was a significant difference in thrombosis rate between lines sited with the tip in a distal compared with a proximal position (p<0.0005). CVC with tips in a proximal position were 16 times more likely to thrombose than those in a distal position. None of the 58 CVC with the tip located in the RA thrombosed or caused complications. CONCLUSION: Distal placement of tunnelled CVC, either in the distal third of the SVC or proximal RA is optimal.
    Citation
    To clot or not to clot? That is the question in central venous catheters. 2004, 59 (4):349-55 Clin Radiol
    Journal
    Clinical Radiology
    URI
    http://hdl.handle.net/10541/78115
    DOI
    10.1016/j.crad.2003.11.015
    PubMed ID
    15041454
    Type
    Article
    Language
    en
    ISSN
    0009-9260
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.crad.2003.11.015
    Scopus Count
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